PT  - JOURNAL ARTICLE
AU  - Victoria Benson
AU  - Hana Müllerová
AU  - Jørgen Vestbo
AU  - Jadwiga Wedzicha
AU  - Anant Patel
AU  - John Hurst
TI  - Gastro-oesophageal reflux disease and exacerbations of COPD in a cohort of 2,135 COPD patients
AID  - 10.1183/13993003.congress-2015.PA4080
DP  - 2015 Sep 01
TA  - European Respiratory Journal
PG  - PA4080
VI  - 46
IP  - suppl 59
4099  - http://erj.ersjournals.com/content/46/suppl_59/PA4080.short
4100  - http://erj.ersjournals.com/content/46/suppl_59/PA4080.full
SO  - Eur Respir J2015 Sep 01; 46
AB  - Background: Gastro-oesophageal reflux disease (GORD) may increase the risk of exacerbations of COPD (ECOPD), but little is known about use of proton-pump inhibitors (PPI) and histamine receptor antagonists (H2RA) and ECOPD.Aim: To evaluate the relationship between self-reported history of GORD, use of PPI/H2RA and future ECOPD in the Evaluation of COPD Longitudinally to Identify Predictive Surrogate Endpoints (ECLIPSE) cohort (SCO104960, NCT00292552).Methods: Multivariable Cox proportional hazards models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between GORD stratified by use of PPI/H2RA, and time to first moderate-severe exacerbation and hospitalized exacerbation.Results: Out of 2,135 COPD patients, GORD was reported in 547 (26%) of patients; 237 (43%) were also taking PPI/H2RA; 126 (6%) reported PPI/H2RA use in the absence of GORD. During the three year follow-up, 1,579 (74%) patients reported at least one moderate-severe exacerbation; 668 (42%) required hospitalization. When compared to patients who did not report GORD or use of PPI/H2RA, the population with GORD and also using PPI/H2RA had a significantly increased risk of exacerbation (HR=1.58, 95% CI=1.35-1.86); the risk was also increased for patients who reported GORD only or use of PPI/H2RA only (HR=1.21 [1.04-1.40] and 1.33 [1.08-1.65], respectively). Similar findings were observed for time to first hospitalized exacerbation.Conclusion: GORD in COPD is highly prevalent. Use of PPI/H2RA and self-reported history of GORD were associated with an increased risk of moderate-to-severe and hospitalized exacerbations.Funded by GSK.